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Technology-Enhanced Peer Support for Depression in Older Adults: Single-Arm Mixed Methods Feasibility Study
Jin Hui Joo1, Alice Xie1, Samuel Van Vleet1
1Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.
Background:
Depression in late life is often compounded by social isolation and barriers to care. There is limited study of technology-enhanced peer support for depression among older adults.
Objective:
This study aimed to assess the feasibility and acceptability of a technology-enhanced peer support intervention to decrease depression among older adults.
Methods:
We used a mixed methods pilot study among adults aged 50 years and older with depression who received a peer support intervention called Peers+. The intervention consisted of 8 weekly video chats and unidirectional texts focused on increasing depression self-care and coping. Data obtained from screening, baseline, postintervention, and 3-month follow-up were used in the analysis to assess preliminary outcomes of the intervention. Mixed effects longitudinal models were used to assess change in depression, and qualitative data were collected and analyzed to identify key themes related to participant experiences.
Results:
A total of 34 older adults with a mean age of 67 (SD 9.57) years participated in the study, and 82.4% (28/34) of participants finished all 8 intervention meetings. Depressive symptoms declined over the course of the study of 35 weeks (F1, 88.8=26.0; β=-.14, 95% CI -0.20 to 0.09; P<.001). Emotional well-being (β=.48, 95% CI 0.26-0.70; P<.001), social functioning (β=.71, 95% CI 0.33-1.09; P<.001), self-efficacy (β=2.29, 95% CI 0.83-3.75; P<.001), and coping (β=2.90, 95% CI 0.24-5.55; P<.001) improved throughout the study period. Participants perceived supportive texts as reinforcing trust between peer coaches, using coping strategies, increasing social connection, and providing accountability for improving self-care. Peer coaches and older adults needed technology support for participation in the study.
Conclusions:
This study demonstrated the feasibility and acceptability of a peer support intervention enhanced by video chats and texts, delivered by older adult peer coaches to an ethnically diverse group of older adults with depression. Study findings indicate that ongoing and accessible technology support contributed to older adult participation and engagement.
